RESUMO
OBJECTIVE: To describe the experiences of youth regarding confidentiality with their healthcare provider and how confidentiality affects their interactions with the healthcare system. STUDY DESIGN: Using MyVoice, a national mixed methods text message poll, 4 qualitative probes were asked to 1268 youth age 14-24 years from July 2017 through December 2017. Respondents were asked about their opinions and experiences with confidentiality in their healthcare. Data were analyzed using a modified grounded theory approach. RESULTS: The overall response rate was 75% (n = 948) with a mean age of 18.6 years (SD = 3.2). Respondents were mostly female (56%) and white (70%) with 44% reporting some college education or greater. Qualitative analysis revealed that the majority of youth have not had a conversation with their provider about confidentiality; many youth think all care should be confidential; youth worry about privacy and future discrimination; and youth may lie about their risk behaviors or not seek healthcare when concerned about confidentiality. CONCLUSIONS: Confidentiality in healthcare is concerning to many youth and affects how they interact with the healthcare system. It is imperative for healthcare providers to discuss confidentiality while building trusting relationships with each youth to provide the highest level of care for this vulnerable population.
Assuntos
Confidencialidade , Satisfação do Paciente , Relações Médico-Paciente , Adolescente , Comunicação , Feminino , Teoria Fundamentada , Pessoal de Saúde , Humanos , Masculino , Participação do Paciente , Pobreza , Privacidade , Pesquisa Qualitativa , Assunção de Riscos , Mídias Sociais , Envio de Mensagens de Texto , Adulto JovemRESUMO
The climate change mitigation mechanism Reducing Emissions from Deforestation and Forest Degradation in developing countries (REDD+) is currently being negotiated under the United Nations Framework Convention on Climate Change (UNFCCC). Integrating biodiversity monitoring into REDD+ facilitates compliance with the safeguards stipulated by the UNFCCC to exclude environmental risks. Interviews with actors engaged in REDD+ implementation and biodiversity conservation at the national and sub-national level in Peru (n = 30) and a literature review (n = 58) were conducted to pinpoint constraints and opportunities for monitoring effects of REDD+ management interventions on biodiversity, and to identify relevant biodiversity data and indicators. It was found that particularly sub-national actors, who were frequently involved in REDD+ pilot projects, acknowledge the availability of biodiversity data. Actors at both the national and sub-national levels, however, criticized data gaps and data being scattered across biodiversity research organizations. Most of the literature reviewed (78 %) included indicators on the state of certain biodiversity aspects, especially mammals. Indicators for pressure on biodiversity, impacts on environmental functions, or policy responses to environmental threats were addressed less frequently (31, 21, and 10 %, respectively). Integrating biodiversity concerns in carbon monitoring schemes was considered to have potential, although few specific examples were identified. The involvement of biodiversity research organizations in sub-national REDD+ activities enhances monitoring capacities. It is discussed how improvements in collaboration among actors from the project to the national level could facilitate the evaluation of existing information at the national level. Monitoring changes in ecosystem services may increase the ecological and socioeconomic viability of REDD+.
Assuntos
Biodiversidade , Conservação dos Recursos Naturais , Árvores , Mudança Climática , Países em Desenvolvimento , Peru , Fatores SocioeconômicosRESUMO
Leptospires exist as saprophytic organisms that are aquatic or as pathogens that are able to survive in water. Leptospirosis is transmitted to humans through environmental surface waters contaminated by the urine of mammals, usually rodents, which are chronically infected by pathogenic strains. The ecology of Leptospira spp. prompted us to evaluate if these spirochaetes were able to form biofilms. This study investigated the characteristics of biofilm development by both saprophytic and pathogenic Leptospira species using microscopic examinations and a polystyrene plate model. Biofilms were formed preferentially on glass and polystyrene surfaces. Electron microscopic images showed cells embedded in an extracellular matrix. The formation of such a biofilm is consistent with the life of saprophytic strains in water and may help pathogenic strains to survive in environmental habitats and to colonize the host.
Assuntos
Biofilmes/crescimento & desenvolvimento , Leptospira/fisiologia , Animais , Microbiologia Ambiental , Vidro , Humanos , Leptospira/citologia , Leptospira/isolamento & purificação , Leptospira/ultraestrutura , Leptospirose/microbiologia , Microscopia , Microscopia Eletrônica de Varredura , PoliestirenosRESUMO
Retrospectiva: O citrato de clomifene tem sido utilizado em pacientes ovuladoras com a intençao de melhorar os índices de gravidez. Objetivo: O objetivo do presente trabalho foi comparar as variaços hormonais (LH e androstenediona), as respostas ovariana (número de folículos dominantes e índice de ovulaçao) e endometrial (espessura) e os índices de gravidez obtidos por diferentes doses de citrato de clomifene e em ciclos espontâneos, em pacientes com ciclos ovulatórios. Casuistica e Metodos: Foram estudadas 38 pacientes com esterilidade sem causa aparente, tratadas de 4 maneiras: citrato de clomifene 25 mg/dia (1O pacientes), citrato de clomifene 50 mg/dia (9 pacientes), citrato de clomifene 100 mg/dia (3 pacientes) e ciclo espontâneo (1O pacientes). Resultados: Houve somente diferença estatisticamente significativa em relaçao à espessura do endométrio (pAssuntos
Humanos
, Feminino
, Adulto
, Citratos/farmacologia
, Clomifeno/farmacologia
, Ovulação
, Androstenodiona/sangue
, Endométrio
, Hormônio Luteinizante/sangue
, Folículo Ovariano
, Indução da Ovulação
, Gravidez
, Estudos Prospectivos